Tendons
A tendon (or sinew) is a tough band of fibrous connective tissue that usually connects muscle to boneeMedicine/Stedman Medical Dictionary Lookup! and is capable of withstanding tension. Tendons are similar to ligaments and fascia as they are both made of collagen except that ligaments join one bone to another bone, and fascia connect muscles to other muscles. Tendons and muscles work together and can only exert a pulling force. Structure Normal healthy tendons are composed of parallel arrays of collagen fibers closely packed together. The fibers are mostly collagen type I, however there are also collagen type III and V present. These collagens are held together with other proteins, particularly the proteoglycan, decorin and, in compressed regions of tendon, aggrecan. The tenocytes produce the collagen molecules which aggregate end-to-end and side-to-side to produce collagen fibrils. Fibril bundles are organized to form fibers with the elongated tenocytes closely packed between them. Collagen fibers coalesce into macroaggregates. Groups of macroaggregates are bounded by connective tissue endotendon and are termed fascicles. Groups of fascicles are bounded by the epitendon and peritendon to form the tendon organ. Blood vessels may be visualized within the endotendon running parallel to collagen fibers, with occasional branching transverse anastomoses. The internal tendon bulk is thought to contain no nerve fibers, but the epi- and peritendon contain nerve endings, while Golgi tendon organs are present at the junction between tendon and muscle. Tendon length varies in all major groups and from person to person. Tendon length is practically the discerning factor where muscle size and potential muscle size is concerned. For example, should all other relevant biological factors be equal, a man with a shorter tendons and a longer biceps muscle will have greater potential for muscle mass than a man with a longer tendon and a shorter muscle. Successful bodybuilders will generally have shorter tendons. Conversely, in sports requiring athletes to excel in actions such as running or jumping, it is beneficial to have longer than average Achilles tendon and a shorter calf muscle. Tendon length is determined by genetic predisposition, and has not been shown to either increase or decrease in response to environment, unlike muscles which can be shortened by trauma, use imbalances and a lack of recovery and stretching. Function Tendons have been traditionally considered to simply be a mechanism by which muscles connect to bone, functioning simply to transmit forces. However, over the past two decades, much research focused on the elastic properties of tendons and their ability to function as springs. This allows tendons to passively modulate forces during locomotion, providing additional stability with no active work. It also allows tendons to store and recover energy at high efficiency. For example, during a human stride, the Achilles tendon stretches as the ankle joint dorsiflexes. During the last portion of the stride, as the foot plantar-flexes (pointing the toes down), the stored elastic energy is released. Furthermore, because the tendon stretches, the muscle is able to function with less or even no change in length, allowing the muscle to generate greater force. Pathology Tendinitis refers to inflammation of a tendon. Tendinosis refers to non-inflammatory injury to the tendon at the cellular level. The tendons in the foot are highly complex and intricate. If any tendons break it is a long painful healing process, not to mention the intricacy of the repairing (if fully severed) process. Most people that do not receive medical attention within the first 48 hours of the injury will suffer from severe swelling, pain, and an on-fire feeling where the injury occurred. They are very painful when they are inflamed or not in use. See also *Aponeurosis *Carpal tunnel syndrome *Chordae tendineae *Cartilage *Tendon sheath References Further reading Papers *Alfredson, H. (2005). The chronic painful Achilles and patellar tendon: Research on basic biology and treatment: Scandinavian Journal of Medicine & Science in Sports Vol 15(4) Aug 2005, 252-259. *Alfredson, H. (2006). Strategies in treatment of tendon overuse injury. The chronic painful tendon: European Journal of Sport Science Vol 6(2) Jun 2006, 81-85. *Arslan, Y. Z., Hacioglu, Y., & Yagiz, N. (2008). Prosthetic hand finger control using fuzzy sliding modes: Journal of Intelligent & Robotic Systems Vol 52(1) May 2008, 121-138. *Bastin, J., Calvin, S., & Montagne, G. (2006). Muscular proprioception contributes to the control of interceptive actions: Journal of Experimental Psychology: Human Perception and Performance Vol 32(4) Aug 2006, 964-972. *Brunia, C. H., & Van Boxtel, A. (1978). 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